natality control methods than was previously the case. Most specify natality goals that are based upon contraceptive utilization rates that are presumed will occur under voluntary family planning in response to a proposed level of availability of information, service, and supplies at an assumed level of public motivation or of demand potentially present.
In these circumstances (which will almost certainly be altered in some countries by 1985) expenditures for natality control and family planning are considered here as identical.
Family planning expenditures shown in Table 5 are governmental (public sector) expenditures only (although some are used to purchase services in the private sector). The countries were selected because they had national programs at least 3 years old for which expenditure data were available. Since the programs are still in various stages of development in all countries, expenditures per capita are still rising. Levels of at least 10 to 20 U.S. cents per person per year—the same order of magnitude as the cost of malaria-eradication programs (26)-appear necessary in LDC's.
FUTURE LEVELS OF HEALTH SERVICES (1985)
Projecting alternative trends of the factors which affect development of the LDC's—even for 20 years—is becoming as sterile as predicting the most likely combination and outcome is becoming hazardous, but both are necessary for rational planning of man's future.
The effects of population growth on future levels of health services are similar to its effects on other developmental goals which are discussed in this volume—perhaps most like those on education. Levels of health are comparable to levels of knowledge; levels of utilization of health facilities and manpower are comparable to years of schooling; doctor:population ratios to teacher'.enrollment ratios; hospital beds to schoolrooms, medical and nursing colleges to teachers colleges; etc. Despite these similarities, substantial differences also exist; for example, needs for schools and needs for health services have different relationships to the age structure of the population (Figure 2) and to the times required to train personnel (doctors vs. teachers).
The effects of population growth on personal health services depend in part upon the probable effects of other factors besides population which help determine what the levels of doctors, hospital beds, and health expenditures will actually be in 1985. First are national decisions regarding the priority position of health relative to other goals, such as food, education, employment, industry, roads, communications, and income; and regarding priorities among health services, such as malaria eradication, clean, piped drinking water, hospital care, and family planning. In those LDC's where mortality is already approaching low levels, less incentive to invest a larger proportion of national development budgets in mortality and morbidity control is antici-into account the varying medical and cultural